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To the Editor: We support the recommendation of Runciman and colleagues for national agreement on clinical standards of health care,1 and highlight the importance of including routine health promotion activities as a core part of quality care in clinical practice. The indicators used by Runciman et al fail to consider core aspects of preventive care, such as screening and evidence-based behavioural interventions for lifestyle risk factors including smoking, poor diet, high-risk alcohol consumption and physical inactivity. Failure to include these aspects of preventive care is a missed opportunity for reducing the disease burden and promoting health. Indeed, the “health care encounter”1 presents a unique opportunity for changing health behaviours related to these risk factors, as medical practitioners are the most trusted source of health information.2

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